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Environmental Health Department <br /> 10. 1 am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br /> 45°F (if food is used the following day, maintain below 41°F temperature): <br /> Ice chests ❑Refrigerator <br /> ❑ Refrigerated truck ❑ Ice bath and tubs <br /> ❑ Other(specify) <br /> 11. 1 am providing the following items within my booth for the sanitary cleaning of food preparation utensil <br /> ❑Three compartment sink. <br /> OR <br /> ❑ Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br /> solution (one tablespoon of beach per gallon of water). <br /> ❑ Detergent, bleach, and wiping cloths(cleaning towels). <br /> ,q7ub to store wiping cloths in bleach solution. <br /> 12. ,I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br /> booth: <br /> hg�waker supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br /> ❑ One separate tub(bucket or basin) for the collection of rinse/wastewater. <br /> ❑ Paper towels and up mp-s: ley soap container. <br /> 13. Names of responsible persons to be present in booth during all hours of operation: <br /> r'Y>uR Rzf k��fNE . <br /> "*Important" All food vendor booths are subject to inspection. Please make a copy of this application in <br /> preparation for this event. A copy of this checklist must be in the booth at all hours of <br /> Preparation and operation. Return original to festival coordinator three weeks prior to <br /> this event. <br /> 14. Completed by: <br /> 2� <br /> Signatre Title Date <br /> Health PermitjP;h <br /> s-2o Gal <br /> rr('''���' Hand wash Water <br /> [emoG/Chafing <br /> Paper Hand Towels <br /> Soap dispenser <br /> Cutting Board <br /> Sanihzer bucket- <br /> r,opane Stove bleach&water for <br /> Lileac storing. prig cloths <br /> Booth must be on <br /> Concrete,Asphalt, <br /> P opane Tank <br /> Plywood,or a Tarp. <br /> Soap and Water Rrnse Water Bleach and Water <br /> Garbage <br /> Fire Ex4ngusher Can <br /> Extra <br /> Water <br /> Ice Cooler <br /> S Gal Hand wash <br /> Erb'a Ice 63gs B Food C ontaZ must be Wastewater Container <br /> stored 6 inches c9 0/the ground' <br /> 1568; E HazeltOn Avenue ; Stocktar. California52u5 T 209 456-3420 i F 209 464-013$ er+vw.sjgov.orglettd <br /> EHD 76-02 <br /> 07/07!2024 Page a of 11 <br /> TEMP EVENT APP <br />